OBLIQUE PARARECTAL MINIAPPROACH IN APPENDECTOMY Russian patent published in 2009 - IPC A61B17/00 

FIELD: medicine; surgery.

SUBSTANCE: right iliac region is incised. Anterior abdominal wall is incised from linea biiliaca or 1-2 cm lower. Incision length is 2 to 5 cm depending on patient's constitution and body-weight index. Incision direction from the point between external and middle third of line, connecting navel and right anterior superior iliac spine, in parallel to femoral arch to right lateral edge of rectus. Further aponeurosis of abdominal external oblique muscle is dissected along aponeurotic fibres from border of muscle fibre ending and transition to anterior wall of rectus sheath. Rectus sheath is dissected completely. Aponeurosis of abdominal external oblique muscle is 2-4 cm longer than skin incision. Abdominal internal oblique muscle and transverse muscle of abdomine are bluntly pulled apart at junction of muscle fibres of abdominal internal oblique muscle and aponeurotic.

EFFECT: lower operational injury within incisions along fibres, visualised small pelvis in women without incision dilatation, expanded upward and lateral approach with small injury number.